Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Center for Patient Safety, Aga Khan University Medical College, Karachi, Pakistan.
BMJ Open Qual. 2023 Mar;12(1). doi: 10.1136/bmjoq-2022-002029.
Patient safety is a top priority for many healthcare organisations worldwide. However, most of the initiatives aimed at the measurement and improvement of patient safety culture have been undertaken in developed countries. The purpose of this study was to measure the patient safety culture at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC).
The HSOPSC was used to measure the patient safety culture across 12 dimensions at Aga Khan University Hospital, Karachi. 2,959 individuals, who had been working at the hospital, were administered the HSOPSC in paper form between June and September 2019.
The response rate of the survey was 50%. In the past 12 months, 979 respondents (33.1%) had submitted at least one event report. Results showed that the personnel viewed the patient safety culture at their hospital favourably. Overall, respondents scored highest in the following dimensions: 'feedback and communication on error' (91%), 'organisational learning and continuous improvement' (85%), 'teamwork within units' (83%), 'teamwork across units' (76%). The dimensions with the lowest positive per cent scores included 'staffing' (40%) and 'non-punitive response to error' (41%). Only the reliability of the 'handoffs and transitions', 'frequency of events reported', 'organisational learning' and 'teamwork within units' was higher than Cronbach's alpha of 0.7. Upon regression analysis of positive responses, physicians and nurses were found to have responded less favourably than the remaining professional groups for most dimensions.
The measurement of safety culture is both feasible and informative in developing countries and could be broadly implemented to inform patient safety efforts. Current data suggest that it compares favourably with benchmarks from hospitals in the USA. Like the USA, high staff workload is a significant safety concern among staff. This study lays the foundation for further context-specific research on patient safety culture in developing countries.
患者安全是全球许多医疗保健组织的首要任务。然而，大多数旨在衡量和改善患者安全文化的举措都是在发达国家开展的。本研究的目的是使用医院患者安全文化调查（HSOPSC）来衡量巴基斯坦一家三级保健医院的患者安全文化。
在 2019 年 6 月至 9 月期间，使用 HSOPSC 对卡拉奇的 Aga Khan 大学医院进行了 12 个维度的患者安全文化测量。共有 2959 名在医院工作的人员以纸质形式接受了 HSOPSC 调查。
调查的回复率为 50%。在过去 12 个月中，有 979 名受访者（33.1%）提交了至少一份事件报告。结果表明，员工对医院的患者安全文化持积极态度。总体而言，受访者在以下几个方面的评分最高：“错误反馈和沟通”（91%）、“组织学习和持续改进”（85%）、“单位内团队合作”（83%）、“单位间团队合作”（76%）。评分最低的积极百分比维度包括“人员配备”（40%）和“对错误的非惩罚性反应”（41%）。只有“交接班和过渡”、“报告事件的频率”、“组织学习”和“单位内团队合作”的可靠性高于 0.7 的 Cronbach 阿尔法。对积极反应进行回归分析后发现，与其他专业群体相比，医生和护士对大多数维度的反应不如其他专业群体积极。
在发展中国家，衡量安全文化不仅是可行的，而且具有信息性，可以广泛实施，为患者安全工作提供信息。目前的数据表明，与美国医院的基准相比，它表现良好。与美国一样，高员工工作量是员工面临的一个重大安全问题。本研究为进一步开展发展中国家特定背景下的患者安全文化研究奠定了基础。
